Brenda Hernandez

Gestational Diabetes

My topic is about how gestational diabetes affects pregnancy and how to prevent it.

Gestational diabetes occurs when pregnant women display high blood glucose levels during

pregnancy. This happens when their body cannot produce enough insulin to use which is called

insulin resistance. Gestational diabetes usually develop between the 24th and 28th weeks of

pregnancy or sometimes even before. Gestational diabetes is a very serious matter. It can lead to

health problems not only to the mother but to the fetus as well. For the mother it may advance to

type 2 diabetes in the near future. It is so important for people to be aware of this so they can

seek treatment as soon as possible. This topic interest me a lot because I want to be a labor and

delivery nurse. I am going to be working with moms and babies and this is something that I will

most likely come across. Also, this affects a lot of people and I just want everyone to be at least

aware of what can happen so they can take steps to talk to their doctors and get more information

about it.

The research article “Adiponectin Concentration in Gestational Diabetic Women: a case

control study” states,“Gestational diabetes mellitus (GDM) is one of the most common

pathologic situations in pregnancy…affects approximately 1%-14% of pregnant women”,

(Mohammadi & Paknahad, 2017, p. 1). That may not seem like a lot but studies show that it

increases more and more by the years. Furthermore, it also adds that they can later on have the

risk of developing type 2 diabetes seven times the rate of a healthy mother (Mohammadi,

Paknahad, 2017). Type 2 diabetes is a common type of diabetes that most people get. It usually

develops from not producing enough insulin. Quite a few components can contribute to

gestational diabetes such as family history of GDM, obesity, past delivery of a large baby and
high maternal age (Mohammadi, Paknahad, 2017). This article analyzed the association between

glucose intolerance and adiponectin levels to GDM . It is important to note that adiponectin is a

hormone in which it regulates energy homeostasis and lipid metabolism and carbohydrate

(Mohammadi, Paknahad, 2017). It has been said that maternal adiposity can have an impact on

insulin resistance which could advance to gestational diabetes melitus.

Numerous studies shows that women with low adiponectin levels are 5-6 times higher in

getting gestational diabetes (Mohammadi, Paknahad, 2017). They examined the effects of pre-

pregnancy BMI (body mass index) and adiponectin concentration. Unsurprisingly, gestational

diabetes was a main factor. Those who had low levels of adiponectin and with a body mass index

less than 20 were at a much higher risk of developing gestational diabetes melitus. “...decline in

adiponectin concentration increased the risk of GDM about 20%,” (Mohammadi, Paknahad,

2017, p. 2) is what one studied showed. Another one was “...reduction in maternal adiponectin

levels was an indicator of 4.6 times increased chance of GDM”, (Mohammadi, Paknahad, 2017,

p. 3). More studies showed similar outcomes. This article proposes that adiponectin be used as a

tool to detect metabolic dysfunctions such as gestational diabetes. This article I found very useful

because it may benefit presume the risks of GDM.

This second article is about the effects of both the mom and the fetus. “Maternal and fetal

outcomes of pregnant women with type 1 diabetes, a national population study,” recorded a total

of 2,350,339 pregnancies with 630 of them having type 1 diabetes (Chang, Chiou, Lin, Kuo, et

al., 2017, p. 1). They compared fetuses of mothers who have type 1 diabetes and those who do

not. Fetuses with diabetic mothers were at a risk of low birth weight, large for gestational age,

premature birth and stillbirth. For mothers, they are at a risk for adult respiratory distress

syndrome, cesarean delivery, eclampsia and preeclampsia (Chang., et al 2017). Respiratory

distress syndrome is when your lungs are not getting enough oxygen because fluid collects in the

air sacs. Cesarean delivery is when the mom has a surgical incision in the abdomen and uterus to

deliver the baby. Eclampsia is when a mother is experiencing a seizure during their pregnancy or

right after delivering. Preeclampsia is a high blood pressure pregnancy complication. All of these

are very dangerous to the mother because their health is at stake as well as their delivery which

could potentially expose the baby to danger. That is why it is so important to help diagnose

gestational diabetes as soon as possible. Not only for the mothers but as well as the babies since

it affects them too.

My third article “The short-term health and economic burden of Gestational Diabetes

Mellitus in China: a modelling study,” also stated that newborns are at risk of being premature

and neonatal respiratory distress syndrome and mothers at risk for caesarean section, maternal

infections, fetal distress syndrome and preeclampsia (Dairelli., et al 2017). In my third article it

intends to estimate the short term health and economic burden of China. In this article it states

that “GDM may lead to serious adverse health outcomes during pregnancy and delivery...likely

to develop type 2 mellitus, and babies are more likely to become obese later on in life”, (Dairelli

et al., 2017, p. 1). Concludes the cost of GDM diagnosis treatment, maternal complications, and

neonatal complications. These cost were selected by the price guidelines and clinical

recommendations which were all confirmed by a panel of hospital practitioners (Dairelli., et al

2017). They got the complications of maternal and neonatal selected by expert opinions and

published literature. Women who were diagnosed with GDM received a week of “lifestyle

interventions” which included health education, exercise and diet. What amazed me the most

about this study is how 80% of them were able to control their blood glucose (Dairelli., et al

2017, p. 2). The other percent were prescribed insulin. On average the cost of pregnancies with
gestational diabetes mellitus is estimated to be $1929.87 more than the average women without

gestational diabetes (Dairelli., et al 2017, p. 4). This study was done in 2015 and their number of

pregnancies that year was 16.5 million with 2.9 million having GDM. Also the social economic

burden is estimated to be 5.59 billion (Dairelli., et al 2017, p. 4).

As of now they are looking into what can be done to prevent gestational diabetes. If the

study where they gave the pregnant women a week of lifestyle tips improved 80% of them I am

not sure why everyone else is not doing it. I know a lot of people in this generation do not like to

walk anywhere or eat healthy but if there is a chance of bettering yourself and your baby why

would you not take it? It is so so important for you to be watching what you are eating while you

are pregnant and even before then too. Walking around the block a few times a week is better

than nothing. Also, pregnant people who do not have gestational diabetes should also be

watching out too because it can happen at any time. Doctors should be talking to their patients

about all the risk and should help them come up with a plan to help them out. Women should be

getting their blood checked frequently by their doctors. Some might be getting insulin injections

as well. Pregnant women should take action right away. Losing weight is a great way to prevent

diabetes early on even if it is just a few pounds. That is why it is also important to get your

physical check ups as well. If you are dieting make sure you do not skip meals or starve yourself.

Balance it out with protein, vegetables, and fruits. It is all about eating healthy and getting at

least an hour of exercise a day. Once the baby is born breastfeeding is the healthiest choice for

your baby as it will give them the nutrition they need as opposed to formula which will just get

them fat. It is important to note once you had gestational diabetes you are at risk of getting it

again in future pregnancies. Also important to note that your risk is higher at getting it again
since you already it the first time. So do not stop eating healthy and continue to do your walking

or any other sort of exercise.

What all my articles had in common was that if you have gestational diabetes you are at

risk for developing type 2 diabetes. Also in my first article it says that multiple articles were

compatible with their results. “This result is compatible with our findings,” (Mohammadi,

Paknahad, 2017, p.4). I believe this statement because if multiple sources are getting the same

results then it has to prove something.. However, not all had the same constants and everyone is

different so it is impossible to get it 100% accurate. You can not track everything because you

would need past information of the patient. It should be noted that if your family has a history of

gestational diabetes than you are at a higher risk for developing it.

In conclusion, gestational diabetes is a very serious disease. You can develop type 2

diabetes even after you have given birth. Your baby can have many complications after they are

born or you can have complications while delivering.. Also, medical treatments can cost you a

lot of money. It is just better to be able to prevent this by just being healthy. Eating right,

exercising, going to your doctor for your check ups are all things that you could be doing to

being able to prevent this or if you already have it then by being able to get rid of it, In my future

career I will definitely educate my patients about gestational diabetes and help them set up a plan

which will include healthy meal plans and some easy exercises they can do for how to prevent it.

We will come up a healthy lifestyle that will help both the mom and the baby. I think that all

doctors should do this with their patients for their well being.

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 References

Chang, S.H., Chiou, M.J., Lin, S. F., & Kuo, C. F. (2017). Maternal and fetal outcomes of

pregnant women with type 1 diabetes, a national population study. Oncotarget, 8(46),

80679. doi:10.18632/oncotarget.20952
Dairelli, L., Detzel, P., Fang, H., Liangkun, M., Xu, T., & Zolezzi, I.R. (2017). The short-

term health and economic burden of gestational diabetes mellitus in China: a modeling

study. BMJ Open, 7(12), e018893. http://dx.doi.org/10.1136/bmjopen-2017-018893

Mohammadi, T., & Paknahad, Z. (2017). Adiponectin concentration in gestational

diabetic women: a case-control study. Clinical Nutrition Research, 6(4), 267-276.

http://doi.org/10.7762/cnr.2017.6.4.267